Vacuum powered saline injection system

ABSTRACT

A method and apparatus for injecting saline into an open cavity of a patient&#39;s body, and, alternatively, vacuuming fluids from said cavity, during laparoscopic surgery that provides constant feed and amplified pressure to provide a steady fluid output, in a disposable, single use handheld surgical device.

TECHNICAL FIELD

The present novel technology relates to the field of medical devicetechnology, and more particularly, a method and apparatus used duringlaparoscopic surgery for injecting saline into an open cavity of thepatient's body, and, alternatively, vacuuming fluids from said cavity.

BACKGROUND

Laparoscopic surgery has continuously gained momentum and popularitysince it was first introduced in the United States around 1988.Laparoscopic surgery, a minimally invasive surgical technique in whichsurgeons operate through multiple, small incisions in the abdomen,reduces standard risks, patient discomfort, scarring, and recovery timecompared to previously utilized open surgical techniques.

Due to the intricate process of utilizing specialized instrumentationand a laparoscope camera to perform the operation while watchingdetailed images on a monitor, a clear surgical field is important.Without a clear surgical field, the surgeon is essentially operating“blind”. Irrigation and aspiration are essential procedures duringlaparoscopic surgery, especially for maintaining a clear visual fieldand maintained hemostasis. Therefore, it is crucial that the device usedfor irrigation and aspiration provide enough hydraulic pressure to clearaway debris, blood, blood clots, char, or any other material that mayobstruct the surgeon's vision throughout the procedure, without delay.

Typically, disposable, single-use battery-powered laparoscopic devicesare utilized for irrigation and aspiration. These mechanical pumpingsystems typically utilize standard alkaline batteries to power a motor,which in turn, activates a pump to drive irrigation fluid through thesystem for delivery to the operative site. Although these devicesprovide portable handheld systems with a built-in pump motor andgenerally adequate fluid pressure, there is currently a need for anaspiration and irrigation device that solves several issues unaddressedby the devices currently in the marketplace. The current solution isexpensive and requires multiple disposal methods for proper disposal ofthe various components, such as metal, chemical, and surgical waste. Inaddition, an improved method of operating a pump, utilizing standardoperating room resources, would be more transferable, efficient,inexpensive, and reliable. The present novel technology addresses thisneed.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a front plan view of a vacuum powered saline injection systemaccording to a first embodiment of the present novel technology.

FIG. 2 is a side plan view of a first embodiment illustrating the gunportion of the vacuum powered saline injection system.

FIG. 3 is a front perspective view of a second embodiment vacuum poweredsaline injection system.

FIG. 4 is a front perspective view of a third embodiment vacuum poweredsaline injection system.

FIG. 5 is a front perspective view of a forth embodiment vacuum poweredsaline injection system.

FIG. 6 is a front perspective view of a fifth embodiment vacuum poweredsaline injection system.

FIG. 7 is a front perspective view of a front perspective view of asixth embodiment vacuum powered saline injection system.

FIG. 8 is a front plan view of the first embodiment vacuum poweredsaline injection system illustrating both the pump portion and the gunportion.

FIG. 9 is a side plan view of a seventh embodiment illustrating theaccumulator portion of a vacuum powered saline injection system in itscontracted state.

FIG. 10 is a side plan view of the seventh embodiment illustrating theaccumulator portion of a vacuum powered saline injection system in itsexpanded state.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

For the purposes of promoting an understanding of the principles of thenovel technology and presenting its currently understood best mode ofoperation, reference will now be made to the embodiments illustrated inthe drawings and specific language will be used to describe the same. Itwill nevertheless be understood that no limitation of the scope of thenovel technology is thereby intended, with such alterations and furthermodifications in the illustrated device and such further applications ofthe principles of the novel technology as illustrated therein beingcontemplated as would normally occur to one skilled in the art to whichthe novel technology relates.

FIGS. 1-2 and FIG. 8 illustrate a first embodiment of the present noveltechnology, a disposable, single-use handheld surgical device 10 foraspiration, and alternatively, irrigation during surgical proceduressuch as laparoscopic procedures. The vacuum powered saline injectionsystem 10 generally includes a pump portion 15 and a wand or gun portion20, and typically, a plurality of tubing portions 30, one of whichoperationally connects the pump 15 and gun portions 20 of the surgicaldevice 10.

The pump portion 15 generally includes a housing 12, which iscustomarily defined by a base portion 14 and an engageable cover portion(not illustrated in the drawings). Housing 12 is typically made of hardplastic or the like, although any convenient material may be selected.The housing 12 encases a pump motor 55, which typically includes aspring-biased valve 50 having a pivotable pump 13 connected in fluidiccommunication with a vacuum inlet 40, a generally cylindrical lowerfluid storage chamber 70 (typically made of plastic or other polymericmaterial or the like) operationally connected to the spring-biased valve50 and pivotable pump 13, a rod 17 extending vertically through thelower chamber 70 and down into the spring-biased valve 50 and pivotablepump 13, a generally cylindrical upper chamber 60 (typically made ofplastic or other polymeric material or the like) in pneumaticcommunication with the lower chamber 70, a saline inlet 80 connected tothe upper chamber 60, a generally cylindrical spring-biased accumulatoror storage tank 90 (typically made of plastic or other polymericmaterial or the like) connected in fluidic communication to the upperchamber 60, and an outlet 95 for connecting the pump portion 15 and thegun portion 20 of the system 10 by way of a tubing component 33, influidic communication with the upper chamber 60 and flexible plastictubing 30.

A vacuum source is connected in fluidic communication with inlet 40. Thevacuum source is likewise connected to the lower chamber 70 throughpivotable pump 13, such that when a partial vacuum is introduced, airpressure differentials are generated and air pressure urges disk member35 against spring 45B, moving disk 35 toward pump 13, likewise pushingrod 17 into receptacle 18 and urging pivotable pump disk 13 to pivot ina first direction. Pivoting pump disk 13 generates a biasing force inspring 45A, which urges pivoting of disk 13 in a second, oppositedirection. Disk 13 pivots in the first direction until port 43 is openedto atmosphere, allowing air into fluidic communication with vacuumsource and disk member 35, reducing the pressure differential andenabling spring 45A to urge pivoting of disk 13 in the second, oppositedirection and spring 45B to urge disk 35 away from disk 13. As disk 13pivots in the second direction, port 43 is closed to atmosphere, airpressure in disk area 13 and around spring 45B under disk 35 decreases,and the pump circle repeats.

The side of disk 35 opposite spring 45B is connected to plunger 61 whichis disposed inside upper cylinder 60. Movement of disk 35 towards disk13 draws plunger 61 away from cylinder 60, generating a partial vacuumin cylinder 60 and urging fluid from saline source connected to inlet 80through check valve 19 and into cylinder 60. As plunger 61 travels backinto cylinder 60, saline therein is urged through check valve 21 intochamber/storage tank 90, urging disk 65 to move against spring 45C,compressing spring 45C and storing biasing energy therein. When outlet95 is open, saline is urged from the tank 90. The vacuum pump motor 55thus operates to fill tank 90 by urging saline thereinto with a firsturging force. Once the tank is full, spring 45C and theincompressibility of saline generate a second, opposite force urgingsaline from outlet 95 when outlet is open and an unblocked fluid flowpath exists; otherwise, the balance of forces prevent disk 35 frommoving and the pump 55 automatically pauses.

The pump portion 15, gun portion 20, and plurality of tubing components30, are powered by connection to a standard operating room medicalvacuum system, allowing the vacuum powered saline injection system 10 tobe utilized in most surgical and/or operating rooms. A first tubingcomponent 31, has a proximal end 31A operationally connected to a fluidinlet port within the spring-biased valve 50 and pivotable pump 13, anda distal end 31B having a generally elastic, hydrocarbon polymerconnector 180 operatively designed to engage a standard operating roommedical vacuum system. In other embodiments, the connector 180 is sizedand configured to engage non-standard vacuum sources, such asstand-alone vacuum pumps.

In operation, a flushing agent, such as isotonic saline, may be drawnfrom the distal end of a second tubing component 32, having a proximalend 32A operatively designed to engage a flushing agent from an outsidesource, and a distal end 32B in fluidic communication with the upperchamber 60 through a fluid inlet port 80. A generally T-shaped connector63 made out of hard plastic, although any convenient material may beselected, is oriented within a first major axis, perpendicular to agenerally small upper chamber 60 and in fluidic communication with boththe upper chamber 60 and the spring-biased storage chamber 90, containsa plurality of typically round check valves, a first check valve 19 anda second check valve 21, to channel the incoming flushing agent betweenthe upper chamber 60 and the spring-biased storage chamber 90. As theflushing agent enters the system 10 through the fluid inlet port 80, afirst check valve 19 allows the flushing agent to enter the system 10while a second check valve 21 blocks the flushing agent from passingthrough the generally T-shaped connector 63 to the spring-biased storagechamber 90. As the flushing agent enters the system 10, thespring-biased valve 50 and pivotable pump 13 operationally connected toa vacuum source, continuously cycle, urging a rod 17, generallyconnected to a first spring biased disk member 35 and typicallyextending vertically through the lower chamber 70 down into thespring-biased valve 50, to engage the spring-bias 45 located within thespring-biased valve 50 to close a first port 43 operationally connectedto an atmospheric opening. While a second port 42 operationallyconnected to a vacuum source is open, the first spring-biased diskmember 35 is forced to draw against the biasing force and away from theupper chamber 60, producing a partial vacuum in the upper chamber 60,drawing the flushing agent into the upper chamber 60 and down into thelower chamber 70 as the spring-biased disk member 35 is compressed. Asthe pivotable pump 13 cycles, the spring-biased valve 50 forces a secondport 42 operationally connected to a vacuum source to close, opening thefirst port 43 operationally connected to atmospheric air. Theatmospheric air entering the system 10 negates the vacuum force enteringthe system, allowing the spring-bias 45 to urge a first spring-biaseddisk 35 positioned in the lower chamber 70, back towards the upperchamber 60, drawing the flushing agent back into the upper chamber 60.As the flushing agent is drawn back into the upper chamber 60 from thelower chamber 70, the first check valve 19 located within the generallyT-shaped connecter 63 moves towards the saline port 80 to block fluidfrom entering the vacuum powered saline injection system 10 from anoutside source, forcing the flushing agent from the upper chamber 60into the spring-biased storage chamber 90, containing a secondspring-biased disk member 65. The method of forcing a flushing agentfrom the lower chamber 70 into a generally smaller upper chamber 60,while also forcing the flushing agent into the spring-biased storagetank 90 as the system 10 cycles, enables the system 10 to provideconstant feed with amplified pressure, and thus, provide a constant,steady fluid output stream through a third tubing component, 33, havinga proximal end 33A removably connected to the gun portion 20 of thesystem, and a distal end 33B in fluidic communication with thespring-biased storage chamber 90 through an inlet 95. The fluid outputof the system 10 is controlled by the user through a multi-positionvalve 130 located on the gun portion 20 of the system, discussed in moredetail herein. The vacuum powered pump further comprises an automaticshutoff feature when the spring-biased storage chamber 90 back pressureis equal to pump pressure forcing the fluid flow to cease through thesystem, the pivotable spring-biased pump 13 to stop pivoting, and thepump to idly wait until fluid is extracted from the storage chamber 90.

FIG. 2 generally illustrates the gun portion 20 of the vacuum poweredsaline injection system 10. The gun portion 20 (typically made of hard,electrically non-conducting plastic or the like, although any convenientmaterial may be selected) is generally “L”-shaped, and is more typicallyergonomically contoured for comfort and ease of use. The gun portion 20typically contains a first inlet 140 for receiving a tubing component 33to place the pump portion 15 in fluidic communication with the gunportion 20 through a tubing inlet 141 located within the pistol-shapedhandle 100, and a second inlet 145 for receiving a vacuum tubingcomponent 147, located on the underside of the pistol-shaped handle 100,through a second tubing inlet 146 located within the pistol-shapedhandle 100, in fluidic communication to the storage chamber 90, as wellas the operating room vacuum source. Additionally, a fluid nozzle 110located on the barrel portion of the gun 150 places the handle 100 andbarrel portions of the gun 150, including the vacuum tubing inlet 146,as well as the saline tubing inlet 141, in fluidic communication withthe cannula 160. A multi-position valve 130, located on the top of thehandle between the handle 100 and the barrel 150, permits a surgeon toquickly and easily manipulate whether the vacuum powered salineinjection system 10 is in irrigation, aspiration, or off mode by simplyrotating the typically circularly rounded valve 130 to the forwardposition, center, or back position. The multi-position valve 130 alsopermits a surgeon to control the flow and rate of a flushing agent, suchas isotonic saline solution, or the rate and pressure of the vacuum.Thus, the gun portion's 20 functionality permits a surgeon to controlaspiration or irrigation, as well as utilize a diathermy hook 175located inside of a generally elongated cannula 160, without having touse additional tools, reach away from the operating table, and/orphysically move to control the function of the system.

The generally hollow, cylinder-shaped cannula 160 houses a typicallyL-shaped spring-biased diathermy hook 175 that may be extended from thecannula 160 through an opening located on the distal end of the conduit160. The diathermy hook 175 is typically made of surgical stainlesssteel or metal, although any convenient material may be selected, and isoperationally connected to the moveable trigger 170 located on thebarrel portion 150 of the gun handle 100. Actuation of the trigger 170extends the hook from within the distal end of the cannula 160 inrelative relation to the location of the trigger 170, to aid in clearingunwanted tissue beside linear structures during surgery.

Additional embodiments follow, wherein the vacuum powered salineinjection system 10 operates as described above, however, the valvesystems of the vacuum motor and the pump location differ. Morespecifically, the spring-biased valve 50 and the lower chamber 70illustrated in FIG. 1 are replaced by alternative embodiments.

In an alternate embodiment, as illustrated in FIG. 3, a magneticallytriggered valve system 200 cycles the saline pump assembly 235 byopening the vacuum chamber 240 to atmosphere when activated. Magnets(not shown), located on both the sliding valve gate (not shown) and thewall of the vacuum chamber 240, provide attractive and repulsive forcesthat allow the valve gate (not shown), located on the syringe pump 230,to move between alternating open and closed positions. In operation, thesliding gate valve (not shown) is initially in closed position sealingthe vacuum chamber 240. As a vacuum is created within the vacuum motor205, the atmospheric pressure pushes the syringe pump 230, compressingthe spring bias 226 within the vacuum chamber 240 and the spring bias225 within the accumulator 236, drawing a flushing agent such as salineinto the attached spring bias syringe pump 230. As the syringe pump 230passes the magnet (not shown) affixed to the vacuum chamber wall, themagnet embedded in the sliding valve gate (not shown) is repelled,allowing atmosphere to equalize in the vacuum chamber 240. The energystored in the vacuum chamber 240 spring bias 226 pushes the syringe pump230, discharging the saline. As the syringe pump 230 returns to the homeposition with the sliding valve gate (not shown) in closed position, themagnet in the sliding valve gate is attracted to the chamber mountedwall magnet, sealing the vacuum chamber 240 and concluding the strokecycle.

In another alternate embodiment, as illustrated in FIG. 4, a roller ballvalve system 300 contains a lifter 305 that is operationally attached tothe motor plunger 360 within the vacuum chamber 315 that actuates aspring-loaded roller ball 320 that opens and closes the atmosphericinlet 307 allowing atmosphere into the vacuum chamber 315. Whileengaging a vacuum source, vacuum is applied to the vacuum chamber 315and atmosphere pushes the motor plunger (not shown) and check valve 310which drives the lifter 305 and compresses the motor spring 325. Thespring-loaded roller ball 320, located in a slotted track 308 of thelifter 305 containing an independent spring-loaded push-rod 330,compresses forcing the roller ball valve 355 to open the vacuum chamber315 to atmosphere and close the vacuum supply port 335. Thereafter, themotor spring 325 releases, pushing the motor plunger (not shown) andattached saline chamber accumulator 350 to discharge saline through theattached syringe pump 340 and return to home position wherein the sloton the lifter 308 returns the roller ball assembly 320 to home position,sealing the vacuum chamber 315 and opening the vacuum supply port 335. Aplurality of O-Rings 345 located between the vacuum chamber 315 andvacuum motor plunger 360, as well as between the saline chamberaccumulator 350 and the accumulator 340, provides a fluid-tight sealwhen required.

In another embodiment, as illustrated in FIG. 5, the vacuum poweredsaline injection system 10 valve contains an over-the-center togglesystem 400 wherein the pump is driven by the linear motion of the motorplunger 405, wherein O-rings 460 are located thereon. A motor plunger405 directly attached to a push-rod lifter 410 located within the vacuumchamber 410 alternatively forces the atmospheric port 445 or the vacuumport 455 to open, and alternately close when the over-the-center spring450 loaded toggle 415 assembly strikes a valve or gate valve 440 that isspring 465 driven.

In an additional embodiment, as illustrated in FIG. 6, an alternateover-the-center toggle valve system 400 contains an adjacent vacuumredirect valve system 420 wherein the vacuum, entering the system 10through a vacuum supply line 437 into vacuum ports 427 is redirected toalternating vacuum chambers 425. Each chamber 425 has a plunger 430operationally connected to a connecting lever 426 via a plunger push-rod428 extending from both sides of the connecting lever 426 to the salinepump. The connecting lever 426 drives a second set of push-rods 431 forthe over-the-center toggle 432 via a spring bias 436, to redirect vacuumflow and the pump.

In an additional embodiment, as illustrated in FIG. 7, the vacuumpowered saline injection system 10 contains a vacuum connection 550 toan inline vacuum redirect valve 500 wherein the over-the-center togglevalve system 505 is comprised of spring loaded levers 510 driven by acentral slotted push-rod 515/540 connected to two vacuum chambers 560.Atmosphere alternately pushes the motor plungers 525 through the use ofcheck valves 565 located between the over-the-center toggle valve centerand the saline pump 545 and saline pump syringes 520, driving thecentral push-rod 515/540 and pumps 530. As the slotted central push-rod515/540 moves the redirect valve 535 that is held in place by springloaded levers 510, the vacuum is applied to each vacuum chamber 560sequentially. The saline pump syringes 520 are positioned in line withthe shown vacuum chambers 560 and are attached to the spring loadedlevers 510 by push-rods 540.

In an alternative embodiment, as illustrated in FIGS. 9 and 10, thesystem 10 functions as described above regarding the first embodiment10, with the exception being that the accumulator 90 has been replacedby an expanding length of hose/tubing 600. The tubing 600 is typicallyself-expanding 602 upon application of fluid pressure and increasedfluid volume causing a restricting force within the hose 600 and, moretypically, self-contracting 601 upon release of the fluid pressure andfluid volume from within the hose 600. The hose 600 is typicallycomposed of two separate and distinct tubes—an inner tube 605 and anouter tube 610, both at least partially encased within an expansionrestrictor sleeves 645, 650. The inner tube 605 is typically formed froma material that is elastic and has the ability to expand from itsrelaxed or unexpanded length when a pressurized fluid is introduced intothe elastic inner tube 605 and expands radially outwardly or laterally,with respect to its length; the radial expansion of the inner tube 605is constrained by the maximum diameter of the non-elastic outer tube610. The outer tube 610 is typically formed from a relativelynon-elastic, relatively soft, bendable, tubular webbing or like materialthat is typically strong enough to withstand internal pressures of up to250 pounds per square inch, (psi).

The hose 600, in its contracted form 601 as illustrated in FIG. 9,results from a lack of force being applied to the inner tube 605,allowing a flushing agent to enter the storage tank or accumulator 90.The fluid pressure within the hose 600 is generated by introducing fluidunder pressure into one end of the hose 600 and restricting the flow ofthe fluid out of the other end of the hose 600, typically controllingfluid passage through the use of washers 660 located on a male coupler615 and a female coupler 620, positioned on opposite ends of theflexible tubing 600. As a pressurized fluid is introduced into theelastic inner tube 605 in its contracted and relaxed state 601, theelastic inner tube 605 begins to expand laterally and longitudinally andthe outer tube 610 begins to unfold and uncompress around thecircumference of the elastic inner tube 605. Consequently, when theinner tube 605 expands to a predetermined degree, the outer tube 610unfolds, and uncompresses along the entire length of the inner tube 605until it reaches the same length as the inner tube 605 in the expandedcondition 602. Also, because the inner tube 605 expands bothlongitudinally and laterally and its expansion is constrained by thenon-elastic outer tube 610, the inner tube 605 fills all of theavailable space inside the non-elastic outer tube 610 and thus thesurface of the unfolded, uncompressed outer tube 601 becomes smooth inthe expanded condition 602 (as depicted in FIG. 10), generating anurging force upon the stored fluid within the accumulator 90 fordischarge of saline from the system 10, when the valve 50 is open.

While the novel technology has been illustrated and described in detailin the drawings and foregoing description, the same is to be consideredas illustrative and not restrictive in character. It is understood thatthe embodiments have been shown and described in the foregoingspecification in satisfaction of the best mode and enablementrequirements. It is understood that one of ordinary skill in the artcould readily make a nigh-infinite number of insubstantial changes andmodifications to the above-described embodiments and that it would beimpractical to attempt to describe all such embodiment variations in thepresent specification. Accordingly, it is understood that all changesand modifications that come within the spirit of the novel technologyare desired to be protected.

What is claimed is:
 1. A system for injecting and removing fluids duringlaparoscopic surgery, comprising: a pump portion; and a wand portionconnected in fluidic communication with the pump portion; wherein pumpportion further comprises: a vacuum powered pump motor; a hoseoperationally connected to the vacuum powered pump motor for connectionto a vacuum source; a fluidic inlet chamber operationally connected tothe vacuum powered pump motor and connectible in fluidic communicationwith a fluid reservoir; a generally cylindrical fluid storage chamberconnected in fluidic communication with the fluid inlet chamber andhaving a first major axis extending therethrough; a first spring-biaseddisk positioned in the storage chamber and oriented perpendicularly withfirst major axis; and a fluid outlet connected in fluidic communicationwith the fluid storage chamber; wherein the wand portion furthercomprises: an elongated cannula; a first fluid inlet port; a firstlength of flexible tubing operationally connected to the first fluidinlet port and operationally connected to the fluid outlet; a secondfluid inlet port; a second length of flexible tubing operationallyconnected to the second fluid inlet port and operationally connectableto the vacuum source; a pivotable valve connected in fluidiccommunication with the first fluid inlet port, the second fluid inletport, and the elongated cannula; wherein when the hose is connected to avacuum source, and the fluid storage chamber is connected to fluidreservoir, the vacuum pump urges fluid from the fluid reservoir with afirst urging force; wherein fluid filling the generally cylindricalstorage chamber moves the first spring-biased disk and generates anopposite urging force.
 2. The system of claim 1 wherein the wand portionfurther comprises a spring-biased hook extending through the cannula anda trigger operationally connected to the spring-biased hook, whereinactuation of the trigger extends the hook from within the cannula. 3.The system of claim 1 wherein the hose and the second fluid inlet areoperationally connected to a vacuum source.
 4. The system of claim 1wherein the vacuum powered pump further comprises: a spring-biased valveoperationally connected to the hose; a large cylinder having a secondmajor axis extending therethrough; a second spring-biased diskpositioned in the storage cylinder and oriented perpendicularly with thesecond major axis and operationally connected to the spring-biasedvalve; and wherein when the spring-biased valve is open, the secondspring-biased disk is in fluidic communication with the hose.
 5. Thesystem of claim 1 and further comprising a first check valveoperationally connected between the inlet port and the inlet chamber anda second check valve operationally connected between the inlet chamberand the storage chamber.
 6. The system of claim 1 wherein when the firsturging force equals the opposite urging force, the vacuum powered pumppauses until fluid is extracted from the storage chamber.
 7. The systemof claim 1 wherein the storage chamber is an at least partially elasticflexible hose.
 8. A disposable surgical device for injecting saline andvacuuming fluids during laparoscopic surgery, comprising: aspring-biased vacuum powered pump motor having a first port; a firstlength of tubing having a first proximal end and a first distal end,wherein the first distal end is operationally connectable to a vacuumsource and the first proximal end is operationally connected to thefirst port; a lower chamber operationally connected to the spring-biasedvacuum pump motor and to the first port; a generally smaller upperchamber in fluidic communication with the lower chamber; a second portconnected in fluidic communication with the generally smaller upperchamber; a second length of tubing having a second proximal end and asecond distal end, wherein the second distal end is operationallyconnectable to a fluid source and the second proximal end isoperationally connected to the second port; an accumulator connected influidic communication with the generally smaller upper chamber; and athird port connected in fluidic communication with the accumulator; athird length of tubing having a third proximal end and a third distalend, wherein the third distal end is operationally connected to a gunportion and the third proximal end is connected in fluidic communicationwith the accumulator; and a cannula in fluidic communication with theaccumulator; wherein the first length of tubing, the second length oftubing, and the third length of tubing are connected, the vacuum pumpurges fluid from the accumulator with a first urging force; whereinfluid filling the generally cylindrical storage chamber generates anopposite urging force.
 9. The device of claim 8 wherein the cannula isoperationally connected to a multi-position control valve and whereinthe multi-position control valve is connected in fluidic communicationwith the fluid source and with the vacuum source.
 10. The device ofclaim 8 and further comprising a diathermy hook extending through thecannula.
 11. The device of claim 8 wherein the diathermy hook isoperationally connected to a spring-biased trigger.
 12. The device ofclaim 8 wherein when the first urging force equals the opposite urgingforce, the vacuum powered pump pauses until fluid is extracted from theaccumulator.
 13. The device of claim 8 wherein the accumulator is anexpandable length of hose/tubing.
 14. An apparatus for maintaining aclear visual field and maintaining hemostasis during laparoscopicsurgery, comprising: a pivotable spring-biased valve operationallyconnected to a first port and to a second port, wherein the first portis operationally connected to an atmospheric opening and the second portis operationally connected to a vacuum source; a vacuum chamberoperationally connected to the pivotable spring-biased valve; aspring-biased disk member located within the vacuum chamber and influidic communication with the spring-biased valve; a small chamber influidic communication with the vacuum chamber; a generally T-shapedconnector connected in fluidic communication with the vacuum chamber andwith a third port; a saline source connected in fluidic communicationwith the third port; a storage chamber containing a spring-biased diskmember; and a fourth port connected in fluid communication with thestorage chamber; wherein the generally T-shaped connector contains afirst check valve positioned between the third port and the smallchamber and a second check valve positioned between the small chamberand a storage chamber; and wherein the fourth port operationallyconnectable to a handheld instrument.
 15. The apparatus of claim 14wherein the handheld instrument further comprises a control valveoperationally connectable to the fourth port and a cannula connected influidic communication with the control valve.
 16. The apparatus of claim14 wherein the handheld instrument contains a diathermy hook locatedwithin the cannula; and a trigger operationally connected to diathermyhook for extending the diathermy hook beyond the cannula.
 17. A methodfor injecting and removing fluids from an open cavity duringlaparoscopic surgery, comprising: connecting a vacuum powered pumpsystem to a vacuum source; pumping saline into a storage chamber; andgenerating an urging force in the storage chamber; wherein filling thestorage chamber causes the vacuum powered pump system to automaticallyshut off when storage chamber back pressure is equal to pump pressure.18. The method of claim 17 and further comprising delivering saline toan open cavity via a cannula.
 19. The method of claim 17 and furthercomprising evacuating excess fluid from the open cavity via the cannula.